Phakic posterior chamber IOLs

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Phakic posterior chamber IOLs

• Cells involved in crystalline lens and capsular
  bag opacification
• Evolution of designs of PPCIOLs
• Relevant aspects of fixation and sizing
• Sizing issue New studies
• Surgical implantation
• Relationship between cataract and myopia
• Cataractogenesis
• Specimens analyzed in our Center
• Mechanisms
• Review of the literature
• Classification of cataracts after phakic IOL
  implantation?

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Third generation Staar ICL
White-to-white 0.5 mm (myopic
eyes) White-to-white 0.5 mm (hyperopic eyes)
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White-to-white?
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Pop M, Payette Y, Mansour M. Predicting sulcus
size using ocular measurements. J Cataract
Refract Surg 2001 271033-1038.

• -43 eyes of 24 patients (34 6 years)
• -Spherical equivalent -25.50 to 8.75, and 4.00
  to 7.50
• -Measurements white-to-white with surgical
  calipers sulcus diameter with composites of UBM
  photographs (50 MHz)
• -Traditional estimation of sulcus size through
  limbal measurement is inadequate limbus size
  alone cannot predict sulcus size

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Werner L, Apple DJ, et al. Correlation between
different measurements within the eye with
relevance for phakic intraocular lens
implantation. J Cataract Refract Surg 2002 (in
preparation)
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No correlation White-to-white and angle-to-angle
(vertical meridian) N 10 eyes
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No correlation White-to-white and sulcus-to-sulcu
s (vertical meridian) N 10 eyes
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No correlation White-to-white and angle-to-angle
(horizontal meridian) N 12 eyes
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No correlation White-to-white and sulcus-to-sulcu
s (horizontal meridian) N 12 eyes
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Anterior segment B-scan with a high-frequency
digital ultrasound system ARTEMIS Developed
at the Cornell University by J. Coleman, R.
Silverman, and D.Z. Reinstein Manufactured by
Ultralink G. Wilserman and S. Phillips
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• Werner L, et al. Evaluation of a new ultrasound
  system for refractive surgery.
• Poster presented at the XX Congress of the ESCRS,
  Nice, France,
• September 2002
• 15 cadaver eyes (9 phakic and 6 pseudophakic)

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Phakic cadaver eye (horizontal meridian)